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HelpTest Code LAB1231898 ToRCH Profile IgG, Serum
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Reporting Name
Torch Profile IgG, SSpecimen Type
SerumOrdering Guidance
To evaluate recent or acute infection with Toxoplasma gondii, order TXM / Toxoplasma gondii Antibody, IgM, Serum.
For patients presenting with presumed acute infection with herpes simplex virus, order HERPB / Herpes Simplex Virus 1 and 2, Qualitative PCR, Blood.
IgG antibodies in patients younger than 6 months of age are typically the result of passive transfer from the mother. To assess possible infection in patients younger than 6 months, consider ordering IgM testing.
Specimen Required
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-inactivated specimen | Reject |
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Specimen Minimum Volume
1.2 mL
Day(s) Performed
Monday through Saturday
Specimen Retention Time
14 daysReport Available
Same day/1 to 3 daysReference Values
Toxoplasma ANTIBODY, IgG
Negative
Toxoplasma IgG
≤9 IU/mL (Negative)
10-11 IU/mL (Equivocal)
≥12 IU/mL (Positive)
RUBELLA ANTIBODY, IgG
Vaccinated: Positive (≥1.0 AI)
Unvaccinated: Negative (≤0.7 AI)
CYTOMEGALOVIRUS
Negative
HERPES SIMPLEX VIRUS (HSV), TYPE 1 AND TYPE 2 ANTIBODIES, IgG
Herpes Simplex Virus (HSV) Type 1, IgG
Negative
Herpes Simplex Virus (HSV) Type 2, IgG
Negative
Useful For
Determining immune status of individuals to the rubella virus following vaccination or prior exposure
Indicating past or recent infection with Toxoplasma gondii, cytomegalovirus, or herpes simplex virus (HSV)
Distinguishing between infection caused by HSV types 1 and 2, especially in patients with subclinical or unrecognized HSV infection
CPT Code Information
86644-CMV
86695-Herpes simplex, type 1
86696-Herpes simplex, type 2
86762-Rubella
86777-Toxoplasma
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TRCHG | Torch Profile IgG, S | 102088-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| HS1G | HSV Type 1 Ab, IgG, S | 51916-5 |
| HS2G | HSV Type 2 Ab, IgG, S | 43180-9 |
| RBG | Rubella Ab, IgG, S | 40667-8 |
| CMVG | Cytomegalovirus Ab, IgG, S | 13949-3 |
| TOXG | Toxoplasma Ab, IgG, S | 40677-7 |
| DEXG6 | Toxoplasma IgG Value | 8039-0 |
| DEXG2 | Rubella IgG Antibody Index | 5334-8 |
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| TOXGP | Toxoplasma Ab, IgG, S | Yes | Yes |
| RBPG | Rubella Ab, IgG, S | Yes | Yes |
| CMVG | Cytomegalovirus Ab, IgG, S | Yes | Yes |
| HS1G | HSV Type 1 Ab, IgG, S | No | Yes |
| HS2G | HSV Type 2 Ab, IgG, S | No | Yes |
Supportive Data
Toxoplasma gondii:
To evaluate the accuracy of the BioPlex Toxoplasma IgG multiplex flow immunoassay, 600 prospective serum samples submitted for routine Toxoplasma IgG testing by the VIDAS enzyme-linked fluorescence immunoassay (ELFA; bioMerieux) were also analyzed in a blinded fashion by the BioPlex assay within a 24-hour period. Samples with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further resolution of discrepant results was performed by sending the samples to the Palo Alto Medical Foundation for testing. The results are summarized below.
Table 1. Comparison between BioPlex and VIDAS Toxoplasma IgG Assays
|
|
Toxoplasma IgG (VIDAS ELFA) |
|||
|
BioPlex Toxoplasma IgG |
|
Positive |
Negative |
Equivocal |
|
Positive |
63 |
2(a) |
6 |
|
|
Negative |
0 |
528 |
0 |
|
|
Equivocal |
0 |
0 |
1 |
|
(a) Both of these serum samples were negative by the Sabin-Feldman dye test at the Palo Alto Medical Foundation Toxoplasma laboratory.
Sensitivity: 100% (63/63); 95% CI: 93.1% to 100%
Specificity: 99.6% (528/530); 95% CI: 98.5% to 99.9%
Overall Percent Agreement: 98.7% (592/600); 95% CI: 97.3% to 99.4%
Rubella:
To evaluate the accuracy of the BioPlex Rubella IgG multiplex flow immunoassay (MFI), 500 prospective serum samples were analyzed in a blinded fashion by the SeraQuest Rubella IgG IEA (Quest International) and the BioPlex Rubella IgG assay. Samples with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further discrepancies were evaluated by the Rubella IgG VIDAS enzyme-linked fluorescent immunoassay (ELFA; bioMerieux, Inc.). The results are summarized below.
Table 2. Comparison between BioPlex and SeraQuest Rubella IgG Assays
|
|
SeraQuest Rubella IgG EIA |
|||
|
BioPlex Rubella IgG |
|
Positive |
Negative |
Equivocal |
|
Positive |
446 |
0 |
0 |
|
|
Negative |
7(a) |
23 |
4 |
|
|
Equivocal |
17 |
0 |
3 |
|
(a) 6/7 samples tested as equivocal by the VIDAS Rubella IgG ELFA.
Sensitivity: 94% (446/470); 95% CI: 92.5% to 96.6%
Specificity: 100% (23/23); 95% CI: 83.1% to 100%
Overall Percent Agreement: 94.4% (472/500); 95% CI: 92.0% to 96.1%
Cytomegalovirus:
To evaluate the accuracy of the BioPlex cytomegalovirus (CMV) IgG multiplex flow immunoassay, 598 prospective serum samples submitted for routine CMV IgG testing by the VIDAS ELFA (bioMerieux) were also analyzed in a blinded fashion by the BioPlex assay within a 24-hour period. Samples with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further resolution of discrepant results was performed by using the Diamedix CMV IgG enzyme immunoassay. The results are summarized below.
Table 3. Comparison between BioPlex and VIDAS CMV IgG Assays
|
|
CMV IgG (VIDAS ELFA) |
|||
|
BioPlex CMV IgG |
|
Positive |
Negative |
Equivocal |
|
Positive |
336 |
2(a) |
0 |
|
|
Negative |
3(b) |
254 |
3 |
|
|
Equivocal |
0 |
0 |
0 |
|
(a) Both serum samples were negative by the Diamedix CMV IgG EIA
(b) All 3 serum samples were negative by the Diamedix CMV IgG EIA
Sensitivity: 99.1% (336/339); 95% CI: 97.3% to 99.8%
Specificity: 99.2% (254/256); 95% CI: 97.0% to 100%
Overall Percent Agreement: 98.7% (590/598); 95% CI: 97.3% to 99.4%
Herpes Simplex Virus Type 1:
To evaluate the accuracy of the BioPlex herpes simplex virus (HSV) assay, 505 prospective serum samples were tested by EIA (HerpeSelect, Focus Diagnostics) and the BioPlex HSV-1/2 IgG assay. Samples that had discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further discrepancies were evaluated by glycoprotein G (gG) type-specific Western blot (WB) at the University of Washington Virology laboratory. The results are summarized in Tables 4 and 5 below:
Table 4. Comparison between BioPlex and HerpeSelect HSV-1 Assays
|
HSV-1 by HerpeSelect EIA |
||||
|
BioPlex HSV-1 IgG |
|
Positive |
Negative |
Equivocal |
|
Positive |
254 |
5(a) |
0 |
|
|
Negative |
2(b) |
240 |
1 |
|
|
Equivocal |
0 |
3 |
0 |
|
(a) All 5 specimens were positive by WB
(b) Both of these specimens were positive by WB
Sensitivity: 99.2% (254/256); 95% CI: 97.0% to 99.9%
Specificity: 96.8% (240/248); 95% CI: 93.7% to 98.5%
Overall Percent Agreement: 97.8% (494/505); 95% CI: 96.1% to 98.8%
Table 5. Comparison between BioPlex and HerpeSelect HSV-2 Assays
|
HSV-2 by HerpeSelect EIA |
||||
|
BioPlexHSV-2 IgG |
|
Positive |
Negative |
Equivocal |
|
Positive |
115 |
9(a) |
2 |
|
|
Negative |
1(b) |
376 |
0 |
|
|
Equivocal |
1 |
1 |
0 |
|
(a) Two of these 9 specimens were positive by WB, 2 of these 9 specimens were equivocal by WB.
(b) This specimen was negative by WB
Sensitivity: 98.3% (115/117); 95% CI: 93.6% to 99.9%
Specificity: 97.4% (376/386); 95% CI: 95.2% to 98.7%
Overall Percent Agreement: 97.2% (376/386); 95% CI: 95.4% to 98.4%
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.